Open Window Thoracostomy Treatment of Empyema Is Accelerated by Vacuum-Assisted Closure

Palmen, Meindert; Breugel, Henrica N.A.M. van; Geskes, Gijs; Belle, Arne van; Swennen, Jos M.H.; Drijkoningen, André H.M.; Hulst, R.R. van der; Maessen, Jos G.

doi:10.1016/j.athoracsur.2009.06.030

Cited by 76 publications

(66 citation statements)

References 8 publications

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“…system has been reportedly used in the pleural space after open-window thoracostomy [7][8][9][10][11][12][13]. Results showed sufficient space reduction due to re-expansion of the residual lung, healthy granulation tissue formation in the pleural space, and no complications related to the direct application of polyurethane foam to the pleural surface.…”

Section: Discussionmentioning

confidence: 93%

“…Small alveolopleural fistulae do not appear to preclude the use of NPWT [10]. A case report of empyema after right sleeve pneumonectomy showed that a bronchoscopically implanted, bronchial covered stent sealed the anastomotic leak, and the V.A.C.…”

Section: Discussionmentioning

confidence: 98%

“…It is applied on chronic to acute wounds, such as pressure ulcers, diabetic ulcers, problematic surgical wounds, traumatic wounds, and skin grafts [1]. Negativepressure wound therapy is widely applied in the field of thoracic surgery for poststernotomy mediastinitis [2][3][4][5][6], while its use for closure of open-window thoracostomy wounds has recently been attracting attention [7][8][9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

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Successful closure of an open-window thoracostomy wound by negative-pressure wound therapy: report of a case

et al. 2011

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Negative-pressure wound therapy is a newly developed, noninvasive technique to manage a wide variety of wounds. This novel therapy was successfully used to heal the wound after open-window thoracostomy without surgical closure. A 46-year-old woman was admitted to hospital because of a painful mass on the right side of her chest. Radiological findings revealed an abscess on the right chest wall that had ruptured into the right lung and caused empyema. Antibiotic therapy did not yield sufficient improvement. Open-window thoracostomy was performed to achieve a sterile pleural space, and negative-pressure wound therapy was then applied. The pleural space was reduced, and the patient was discharged home with self-administered wound care. The wound healed completely in 5 months without any need for surgical closure.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Successful closure of an open-window thoracostomy wound by negative-pressure wound therapy: report of a case

et al. 2011

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“…Several studies are currently reporting good results from augmentation of the thoracostomy window with a VAC device (73,74).…”

Section: Open Window Thoracostomy +/-Partial Rib Resectionmentioning

confidence: 99%

VATS and open chest surgery in diagnosis and treatment of benign pleural diseases

2017

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A negative pressure normally exists between the visceral and parietal pleurae in the lungs, which can act as vacuum for fluid, air and small particles from different parts of the body, allowing them to move into the pleural space and be retained in it, thus resulting to different manifestations of pleural disorders. A pleural effusion is the result of fluid collection between the parietal and visceral pleural surfaces. The most common cause in developed countries is congestive heart failure, followed by pneumonia and malignancy.It is highly important that a systematic approach is undertaken during the investigation of pleural effusions.Treatment should be based on the nature of the effusion and underlying condition, while undiagnosed patients should remain under surveillance. Pleural infection is a serious clinical condition which affects approximately 65,000 patients every year in the UK and can result in mortality in rates as high as 20%. The selection of treatment as well as timing of intervention remains a debatable issue among pulmonologists and thoracic surgeons. Surgical intervention aims to control sepsis, by facilitating evacuation of necrotic material from the pleural space, and obliterate the empyema cavity, by allowing the trapped lung to re-expand via peeling of the organised cortex from its visceral pleura. Thoracoscopic surgery offers the advantages of visual assessment of the pleural space and direct tissue sampling and it can be useful for the diagnosis of unknown pleural effusions and in the management of complicated collections. Open thoracotomy remains the gold standard, however with the advancement of thoracoscopic instruments and techniques, minimally invasive approaches provide comparable outcomes and have been taking over the management of benign pleural diseases.Keywords: Thoracic surgery; thoracotomy; video-assisted thoracoscopic surgery (VATS); pleural diseases; benign; management; diagnosis; pleural effusion; empyema; chylothorax; pneumothorax Congestive Heart Failure • estimated annual incidence of 500,000 in US. Pneumonia• incidence of 300,000 in US.• 40% of hospitalised patients with pneumonia have an associated parapneumonic effusion. it normally measures below the atmospheric pressure. This allows air to travel into the lungs during an inspiratory effort however it can also act as a vacuum for fluid, air and small particles from different parts of the body, allowing them to move into the pleural space and be retained in it, because of its ability to hold large amounts of liquid or air. A pleural effusion is the result of fluid collection between the parietal and visceral pleural surfaces. Even though a thin layer of fluid is physiologically present in this space for purposes of lubrication and ease of movement of the lung during respiration, in pathophysiological circumstances the fluid can accumulate due to an imbalance of its normal flow, with either too much fluid produced or not enough removed. Pleural effusion can be a manifestation of many different conditions; t...

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“…Thoracic empyema does have some well-established treatment modalities, including the Eloesser flap [3], originally described in 1935 and more recently, the use of negative pressure vacuum therapy [4,5]. Clinicians may encounter a subset of patients who may not completely respond to the described therapy alone or in combination.…”

mentioning

confidence: 99%

Vancomycin Polymethylmethacrylate Bead Plombage Thoracoplasty for Complex Empyema

Olivencia‐Yurvati¹

2017

CSMC

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Open Window Thoracostomy Treatment of Empyema Is Accelerated by Vacuum-Assisted Closure

Cited by 76 publications

References 8 publications

Successful closure of an open-window thoracostomy wound by negative-pressure wound therapy: report of a case

Successful closure of an open-window thoracostomy wound by negative-pressure wound therapy: report of a case

VATS and open chest surgery in diagnosis and treatment of benign pleural diseases

Vancomycin Polymethylmethacrylate Bead Plombage Thoracoplasty for Complex Empyema

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